Friday, May 20, 2011

Last Day of THIS Journey

Today was the last day at the clinic. We are flying out tomorrow. Highlights of today were 1) the snacks and juice that Janet so graciously suggested that we buy and share with patients, families, translators, nurses and children who come to the clinic, and 2) the lapboard I found for Mr. Delille, who finally came back to see me. It was my last time to the supply closet. I thought that maybe, this time, I might not find what I needed. I kept looking and looking and a divine voice inside my head told me to get down on the floor, look under the shelf, behind a box and there I would find the very thing I was looking for—a plexiglass board that fits on a wheelchair to support his right arm. With some adjustments, Andrew (one of the translators and someone who would make a great physical therapist one day) and I attached the lapboard.

He had such significant subluxation that a shoulder sling was just not enough. To make such a wonderful find for Mr. Delille was a fitting way to end the journey at the clinic.

I extend my gratitude to Global Therapy Group for the opportunity to volunteer. I have left a piece of my heart in Haiti and look forward to the day I can come back to feel my heart become whole again.

Thursday, May 19, 2011

Feeling Anxious

From my journal: “Can’t sleep tonight. I am anxious about leaving. I am anxious about the patients we need to see tomorrow.” I especially was worried about Mr. Rousseau at the Pavillion Nursing Home because he was getting skin breakdown and needed a new seating system and schedule for pressure reliefs.

Friday, May 13, 2011

Raymond's Eyes

Today, I cried for Haiti.

I cried alone.

I cried with Janet.

I was overwhelmed with sadness. Raymond, my patient with watery, sparkly blue eyes—he did it. We just connect. And I want to do so much for him and the others that I see. The patients and family members tend to be happy, resolved, welcoming and appreciative of the help that we give. They certainly do not exude sadness. I think my feelings come from a sense that there seems like there is so much to be done, not just with Raymond, but with so many people I have met.

Haiti may need a school to teach physical therapy. There is only training for rehabilitation technicians. My patients following stroke needed occupational therapy and speech therapy, too. I felt deficient in these therapies and longed for consultation with these other health care providers.

A friend from my church told me to keep a journal when I went to Haiti.
So, I did.
My friend told me to make sure I wrote down any of the times that I saw God.
So, I did.
Today, God was in Raymond’s eyes, in Janet’s hug and in all the stories.

Monday, May 9, 2011

Offering Hope

It was on this day, that I felt compelled to write a quote from the Haitian-English Medical Phraseology text in my personal journal. The packet was left on the dresser by my bed to help us translate words like kanpe (“stand up”) and chita (“sit down”). These are the words, that after a few days of working at the Global Therapy Group clinic, I felt like I was beginning to comprehend: “You are here to offer hope to a people that has only too often resigned itself to death. The role of health care is to avoid or relieve suffering; there is more suffering here than in most places. “

Today was my first full day at the clinic. I loved seeing the patients—all of them. Their smiles were bigger, brighter and more numerous than I can remember seeing in one day…ever. My first patient of the day was a young girl with a club-foot deformity who needed a lift for her shoe, to help her compensate for a leg length discrepancy. I wondered if we would have anything in the supply closet that would give her the extra couple of inches that she needed. So, I went searching and found a cast shoe that was almost just the right height, one that she could use with different shoes and made her feel much better!

Trail Magic

About 10 years ago, I went backpacking on the Appalachian Trail, which traverses the mountains from Georgia to Maine, for about 5 months. On rare, surprising occasions, I was able to find exactly what I needed (or maybe just wanted)–such as a cooler full of sodas after hiking 15 miles or the tip for my walking stick to replace the one I wore out completely. This serendipity was coined “Trail Magic”. This is the feeling I had EVERY time I went up to the supply closet. Although the supplies were very loosely organized in some parts of the closet, my trips there always seemed divinely orchestrated and allowed me to provide AFOs, wheelchairs, cushions, canes, arm slings, air casts, splints, and elastic bands to my patients. At times, I might not have found exactly what I thought I needed, but was able to fabricate it, like an arm and wrist splint to fit my patient whose custom splint no longer fit his arm that was weakened by non-use following a stroke.

It seemed that so many of my patients following stroke had exceedingly weaker upper extremities than lower extremities. Not sure why that is. I think education on the concepts of learned non-use and the potential for neuroplasticity and recovery of function are ones that would benefit the patients and families, and possibly nurses and doctors.

The families have so much responsibility for their family member, from the moment he or she is admitted into the hospital and especially after the patient goes home. I had the pleasure of seeing one patient, Madame Marie Martha, from the day following her stroke in the hospital, and later in the clinic after she was discharged home. She was fortunate to have many family members helping her while she was in the hospital…3-4 different, genuinely caring, and concerned people in the room every day. The challenge for me was making sure everyone involved had the same education in order to provide the very best care for her. Everyone needed to know the precautions for protecting her arm during transfers, how to use the gait belt, and the importance of trying to encourage her to do as much for herself as possible during activities of daily living. Hope for recovery increasingly became a focal point of the family and patient education when I worked with patients following stroke. This made patients smile. I felt an increasing obligation to make sure I gave the best care possible so my patients had the best shot at regaining their lives.

Saturday, May 7, 2011

Arriving in Haiti and beginning work at the clinic

We arrived in the morning at the airport and our driver came to pick us up…he had stayed at the airport until late in the evening the night before waiting for us, so was glad that we had finally arrived safely. We had our first experience of being on the roads, scooting in and out and around the crowded streets of Port-au-Prince. Our trip was slowed by a funeral progression in the streets, with loud singing and dancing in front of and behind the casket being carried. It was a bumpy, exhilarating ride and I tried to soak it all in as I began the journey.

We dropped off our bags at Caroline and Henri’s house. They and all of their lovely children would be our hosts, companions and guides…each at different times, sometimes all at once…throughout the next two weeks. I was anxious to get to work at the clinic, since that is what we came to do and we were already late. Saturdays are a shorter day, but there was still time to see one patient, Ruth. She was the first of many patients whose sweet smile and gentleness made for an instant connection. Even though I did not know hardly any Creole, the translators helped me determine that she had some weakness and pain from a previous fracture in her leg. Being 14 years old, her main problem was that she could not run and play with her friends without hurting. So I gave her some exercises and Janet, my friend and fellow PT did some drawings for her home exercise program. I made Ruth laugh when I asked her if she was REALLY going to do the exercises. As she assured me that she would, I thought…I CAN do this (because I was worried about not being confident and not speaking the language well enough) and I that I might really be able to help the patients at the clinic.

Cynthia, a Canadian PT and seasoned volunteer at the clinic, then asked if I wanted to go with her on a home visit with a patient following stroke. Without hesitation, I joined her in the car with the patient’s son and their driver. I was slightly unnerved and concerned by the sight of the driver blessing himself before starting the trip, as well as by him making certain all the doors were locked in the backseat where Cynthia and I were sitting. But, of course, we made it safely, as I did many more times during by two weeks, as Alix became my patient. Before I volunteered, I was worried that I might not be able to help as much as a PT with more experience with patients with amputations, since that seemed to be the injury I heard most about happening after the earthquake. In the United States, I treat mostly patients with neurological problems and was surprised when Donna told me the clinic was seeing a lot of patients following stroke.

In Alix’s home, the porch rail became the parallel bar, the length of the porch became the gym and his very low bed became the mat table for exercises. Although he spoke Creole, French and English, his dysarthria and expressive aphasia led me to use more tactile and visual instructions than words, making spoken language less necessary for treatment. His son, Alex and friend Sonya were exceedingly helpful with physical and communication assistance. And when Sonya turned up the music a bit on the stereo one day, I danced a bit and shared a smile and a laugh, and later hugs. As my friend Janet noticed within hours of being in Haiti, smiles, laughs and hugs have no language barrier.

Friday, May 6, 2011

Charlotte and Janet's Journey Begins

This was the day Janet and I were supposed to arrive in Haiti to begin our volunteer time at the Global Therapy Group clinic. But instead, the generous pilot and owner of the private plane we were in, Jerry Smith, decided not to land in Port-au-Prince at night. Seemed like a prudent thing to do. So, our next option was to land on the island of Exuma in the Bahamas…of course! This was not part of the adventure I expected, but I rolled with it and enjoyed an amazing sunrise before we left for Haiti…again. Highlights of the first day of my journey were seeing a beautiful rainbow with absolutely brilliant greens and purples from the plane—so close we could almost touch it…and later, listening to ABBA on XM channel 70’s on 7 while flying through clouds that looked like the glaciers of Alaska.